Saunders Comprehensive Review for the NCLEX-
PN® Examination
9th Edition
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
INTEGRATED REVIEW — COMPREHENSIVE NCLEX
PRACTICE PACK [FUNDAMENTALS,
PHARMACOLOGY, MEDICAL-SURGICAL,
MATERNITY, PEDIATRIC, EMERGENCY, AND
SPECIALTY SYSTEMS] TEST BANK
FUNDAMENTALS (15 questions)
1 (SBA)
A nurse is delegating tasks on a medical-surgical unit. Which
task is MOST appropriate to assign to an experienced LPN/LVN?
A. Teach a newly admitted patient about self-administered
insulin injections.
B. Administer prescribed oral analgesics to a stable
postoperative client.
C. Perform the initial assessment of a newly admitted client.
,D. Develop the plan of care for a client newly diagnosed with
heart failure.
Answer: B.
Rationale:
A: Teaching about insulin requires independent teaching and
assessment — RN responsibility.
B: Administering oral medications to a stable postop patient is
within LPN/LVN scope when supervised by RN. (Correct)
C: Initial comprehensive assessment is RN role.
D: Developing initial plan of care is RN responsibility (requires
evaluation/complex judgment).
2 (SBA)
A client with a pressure ulcer has necrotic eschar on the heel.
Which intervention should the nurse question?
A. Applying a transparent film dressing over the eschar.
B. Consulting wound care for debridement options.
C. Offloading pressure from the heel with a heel protector.
D. Monitoring for signs of infection (redness, odor, increased
drainage).
Answer: A.
Rationale:
A: Transparent film over a necrotic, non-draining eschar can
trap moisture and impair assessment — typically not
appropriate; eschar often needs debridement. (Correct)
,B: Consulting wound care is appropriate.
C: Offloading pressure is essential.
D: Monitoring for infection is appropriate.
3 (SATA)
Which actions by a nurse reduce the risk of medication
administration errors? (Select all that apply.)
A. Verifying allergies at every medication administration.
B. Using a trailing zero for a dose of 5 mg (written “5.0 mg”).
C. Performing independent double-checks for high-risk
medications.
D. Administering based on a verbal order when the prescriber is
unavailable.
E. Scanning the client’s wristband and medication barcode prior
to administration.
Answers: A, C, E.
Rationale:
A: Confirming allergies each time reduces risk. (Correct)
B: Trailing zeros increase error risk; avoid — write “5 mg” not
“5.0 mg.”
C: Independent double-checks for high-risk meds (insulin,
heparin) are recommended. (Correct)
D: Verbal orders should be limited and verified; often
discouraged unless urgent — not a risk-reduction action.
E: Barcode scanning reduces administration errors. (Correct)
, 4 (SBA)
Which client should the charge nurse assign to a newly licensed
RN (recent graduate) who is competent in basic assessments?
A. A client 24 hours post-open abdominal surgery with stable
vitals.
B. A client admitted with chest pain and ST-elevation on ECG.
C. A client with a tracheostomy requiring tracheostomy tube
change every 4 hours.
D. A client receiving continuous IV alteplase (tPA) infusion.
Answer: A.
Rationale:
A: Stable postop client is appropriate for new RN. (Correct)
B: Chest pain with STEMI needs experienced RN or rapid
intervention.
C: Frequent trach changes suggest high acuity; specialized skills
required.
D: tPA infusion is high-risk and requires experienced RN for
monitoring.
5 (SBA)
Which communication strategy BEST demonstrates therapeutic
communication with an anxious client?
A. “You’ll be fine — I’ve seen this before.”
B. “Tell me more about what is making you anxious.”
PN® Examination
9th Edition
• AUTHOR(S)LINDA ANNE SILVESTRI; ANGELA
SILVESTRI
INTEGRATED REVIEW — COMPREHENSIVE NCLEX
PRACTICE PACK [FUNDAMENTALS,
PHARMACOLOGY, MEDICAL-SURGICAL,
MATERNITY, PEDIATRIC, EMERGENCY, AND
SPECIALTY SYSTEMS] TEST BANK
FUNDAMENTALS (15 questions)
1 (SBA)
A nurse is delegating tasks on a medical-surgical unit. Which
task is MOST appropriate to assign to an experienced LPN/LVN?
A. Teach a newly admitted patient about self-administered
insulin injections.
B. Administer prescribed oral analgesics to a stable
postoperative client.
C. Perform the initial assessment of a newly admitted client.
,D. Develop the plan of care for a client newly diagnosed with
heart failure.
Answer: B.
Rationale:
A: Teaching about insulin requires independent teaching and
assessment — RN responsibility.
B: Administering oral medications to a stable postop patient is
within LPN/LVN scope when supervised by RN. (Correct)
C: Initial comprehensive assessment is RN role.
D: Developing initial plan of care is RN responsibility (requires
evaluation/complex judgment).
2 (SBA)
A client with a pressure ulcer has necrotic eschar on the heel.
Which intervention should the nurse question?
A. Applying a transparent film dressing over the eschar.
B. Consulting wound care for debridement options.
C. Offloading pressure from the heel with a heel protector.
D. Monitoring for signs of infection (redness, odor, increased
drainage).
Answer: A.
Rationale:
A: Transparent film over a necrotic, non-draining eschar can
trap moisture and impair assessment — typically not
appropriate; eschar often needs debridement. (Correct)
,B: Consulting wound care is appropriate.
C: Offloading pressure is essential.
D: Monitoring for infection is appropriate.
3 (SATA)
Which actions by a nurse reduce the risk of medication
administration errors? (Select all that apply.)
A. Verifying allergies at every medication administration.
B. Using a trailing zero for a dose of 5 mg (written “5.0 mg”).
C. Performing independent double-checks for high-risk
medications.
D. Administering based on a verbal order when the prescriber is
unavailable.
E. Scanning the client’s wristband and medication barcode prior
to administration.
Answers: A, C, E.
Rationale:
A: Confirming allergies each time reduces risk. (Correct)
B: Trailing zeros increase error risk; avoid — write “5 mg” not
“5.0 mg.”
C: Independent double-checks for high-risk meds (insulin,
heparin) are recommended. (Correct)
D: Verbal orders should be limited and verified; often
discouraged unless urgent — not a risk-reduction action.
E: Barcode scanning reduces administration errors. (Correct)
, 4 (SBA)
Which client should the charge nurse assign to a newly licensed
RN (recent graduate) who is competent in basic assessments?
A. A client 24 hours post-open abdominal surgery with stable
vitals.
B. A client admitted with chest pain and ST-elevation on ECG.
C. A client with a tracheostomy requiring tracheostomy tube
change every 4 hours.
D. A client receiving continuous IV alteplase (tPA) infusion.
Answer: A.
Rationale:
A: Stable postop client is appropriate for new RN. (Correct)
B: Chest pain with STEMI needs experienced RN or rapid
intervention.
C: Frequent trach changes suggest high acuity; specialized skills
required.
D: tPA infusion is high-risk and requires experienced RN for
monitoring.
5 (SBA)
Which communication strategy BEST demonstrates therapeutic
communication with an anxious client?
A. “You’ll be fine — I’ve seen this before.”
B. “Tell me more about what is making you anxious.”
